Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2016
Multicenter Study Comparative Study Observational StudyComparison of Pediatric Severe Sepsis Managed in U.S. and European ICUs.
Pediatric severe sepsis remains a significant global health problem without new therapies despite many multicenter clinical trials. We compared children managed with severe sepsis in European and U.S. PICUs to identify geographic variation, which may improve the design of future international studies. ⋯ Children with severe sepsis admitted to European PICUs have higher severity of illness, are more likely to be admitted from hospital wards, and receive more intensive care therapies than in the United States. The lack of significant differences in morbidity and mortality after adjusting for patient characteristics suggests that the approach to care between regions, perhaps related to PICU bed availability, needs to be considered in the design of future international clinical trials in pediatric severe sepsis.
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Pediatr Crit Care Me · Jun 2016
Effects of Surfactant Lavage Combined With Intratracheal Budesonide Instillation on Meconium-Injured Piglet Lungs.
To evaluate the combined effects of surfactant lavage and intratracheally instillation of budesonide on meconium-injured piglet lungs. ⋯ Therapeutic bronchoalveolar lavage with diluted surfactant followed by intratracheal instillation of budesonide has a synergistic and beneficial effect when treating severe meconium-injured newborn piglet lungs.
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Pediatr Crit Care Me · Jun 2016
Development of a Prediction Model of Early Acute Kidney Injury in Critically Ill Children Using Electronic Health Record Data.
Acute kidney injury is independently associated with poor outcomes in critically ill children. However, the main biomarker of acute kidney injury, serum creatinine, is a late marker of injury and can cause a delay in diagnosis. Our goal was to develop and validate a data-driven multivariable clinical prediction model of acute kidney injury in a general PICU using electronic health record data. ⋯ We developed and validated the Pediatric Early AKI Risk Score, a data-driven acute kidney injury clinical prediction model that has good discrimination and calibration in a general PICU population using only electronic health record data that is objective, available in real time during the first 12 hours of ICU care and generalizable across PICUs. This prediction model was designed to be implemented in the form of an automated clinical decision support system and could be used to guide preventive, therapeutic, and research strategies.
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Pediatr Crit Care Me · Jun 2016
Clinical TrialParent Satisfaction With Communication Is Associated With Physician's Patient-Centered Communication Patterns During Family Conferences.
To evaluate the association between physician's patient-centered communication patterns and parental satisfaction during decision-making family conferences in the PICU. ⋯ Parent-physician interactions with more patient-centered elements, such as increased proportions of empathetic statements, question asking, and emotional talk, positively influence parent satisfaction despite the child's severity of illness.